Fitbit Fitness Time

I have written previously about my impulsivity and constantly changing exercise kicks and phases. I have a new fitness phase to discuss! I recently purchased a Fitbit after a week long vacation of doing nothing but eating too much and lying on the beach. I researched all the newest activity and heart rate trackers. I knew I did not want to spend more than $200.00 and I wanted it to look subtle enough that I could wear it to work and not have it stand out.

After researching over 5 different trackers (Garmin, Polar, and Basis Peak), I narrowed it down to the Fitbit Charge HR and the Jawbone UP3. The Fitbit was $150.00 and the Jawbone UP3 was $180.00. They were very similar in features including tracking steps, calories, sleep and with wireless apps and syncing capabilities. The big differences were that the Fitbit tracked your heart rate continuously and the Jawbone only tracked your resting heart rate (see the websites for more descriptions on how the heart rate tracking works). Also, the Jawbone had better sleep tracking (your REM, light sleep and awake cycles), but was more expensive and did not have any external display.

So far I have enjoyed wearing the Fitbit Charge. It has definitely made me more aware of the amount of exercise I was getting daily, and it was not nearly as much as I thought! The Fitbit suggests a goal of 10,000 steps a day which is recommended by American Heart Association. I have only achieved over 10,000 steps twice and they have been days where I have been very active, walking over 4.5 miles and am usually very achy and sore the next day. I decreased my step goal to 7500 steps a day and am averaging 5 to 6 thousand a day, meeting my goal of 7500, two to three times a week. It has definitely pushed me to take that extra 30 minute walk on my lunch break, walk up that extra flight of stairs or park farther away at the grocery store. Hopefully it will continue to keep me motivated. Fitbit fitness time!

Rheumatoid Arthritis and Vaccines

I recently got a new job in a hospital setting and as a result all of my immunizations had to be checked to make sure I was not susceptible to any infectious diseases. As a child, I was vaccinated by my pediatrician with the Hep B series, MMR and all the other childhood vaccinations. I have always been vigilant about receiving my yearly flu shots and occasional pneumococcal vaccinations as well. As a person with an autoimmune disease, who is also on immunosuppressant medications (Enbrel),  I have always been on time with my vaccinations and very careful about washing my hands or my contact with people with infections.

So needless to say, I was surprised when I was found to be susceptible to Hepatitis B and Rubella. As I mentioned, whenever you work in hospitals, you need to demonstrate immunity to Hepatitis B in case you have contact with a patient who may carry it. In 2011, I worked in a long-term acute care setting and was found to be susceptible to Hepatitis B. After conversations with my rheumatologist, I received a Hep B booster (one shot) and never really throughout about it again. Until recently..

I was again found susceptible to Hepatitis B in January, only 4 years after my original booster. After more conversations, it was concluded that once again there is not a lot of research about people on immunosuppressant medications and their antibody response to vaccinations. It is thought that the immunosuppressant treatment (biologic medications, chemotherapy, etc.) may decrease their bodies ability to effectively make antibodies to protect themselves from infection from the diseases. Furthermore, even if their body is able to make the appropriate antibodies, the level of protective antibodies may decline quicker than their non-immunosuppressed peer, thus resulting in more frequent need for additional vaccination boosters. (Medscape, 2001)

Fortunately, Hepatitis B is not a live vaccine and only carries part of the disease thus weakening side effects or chance of infection, (vaccine types) and is therefore safe for people on immunosuppressant therapies. So I am once again completing the series of shots in hope to boost my immune response.

However, two weeks later, my test for Rubella (or German Measles) came back "Equivocal" or inconclusive. Meaning they were unable to determine if I had protection or not from this disease. Now I was starting to be worried. Why was my body losing all of it's immunity! After discussing with my rheumatologist again, we decided it may be time to see an infectious disease specialist for further advice. The MMR vaccine (which I had received as an infant) is a live vaccine, which mean it contains much more of the active virus than a inactivated vaccination. Live vaccines do not make healthy people sick or cause any diseases such as Autism (a post for another day!) However, people with weaker immune systems may demonstrate more symptoms or illnesses.

So, receiving the Rubella vaccine would mean not taking my Enbrel for up to a month! This was not something, I wanted to do unless absolutely necessary. At my next medical appointment, I asked to have my immunity to Rubella re-checked, since the initial test was not clear. None of my health professionals had mentioned this even as an option, but I wanted to make absolutely sure it was negative before pursuing more specialists. And it came back positive this time! Fortunately, this means I did not have to stop my Enbrel or see another specialist, for now...

I wanted to share this story because I'm sure some of you have had similar experiences! There definitely needs to be more research on vaccinations and their effect in people with autoimmune diseases. Especially now that some people are choosing to not vaccinate their children, thus exposing many people to potential infections, outbreaks and serious illnesses.

Arthritis National Research Article

I recently had the pleasure of spending a weekend with my adorable 3 month old nephew. Many of my cousins, friends and co-workers have also just had babies or are pregnant. Of course all of the cuteness around me has led me to think about my future baby plans as well. Unfortunately, family planning for a woman with JRA can be more complicated then the typical woman. Many medications need to be stopped 6 months to one year in advance and there are few medical treatment options that have been researched to be safe during pregnancy. Some women experience a remission (or decrease in symptoms) of their RA during pregnancy while others do not.

There have been many times in my life where I have heard that there is not enough research on treatments or long-term effects of JRA or Uveitis. As a child with JRA,  my family often had to balance the risks of unknown medication side effects with improved quality of life and decreased joint damage. There is still not enough research about effective Uveitis treatments. However, I find the lack of research about JRA during pregnancy the most unsettling. JRA affects over 300,000 children, the majority of these young girls. These girls are going to eventually be "All Grown Up" one day soon and will need to make difficult decisions about their medical treatment and decision to have a family with limited research to help guide them.

As a result of this, I chose to be interviewed and share my experience, thoughts and concerns with the Arthritis National Research Foundation (ANRF). You can read my article here, Cure Arthritis Article. The ANRF's mission is to provide initial research funding to scientists with new ideas to cure Arthritis and related autoimmune disease. I hope that sharing my experience will raise awareness and lead to research in this area to help others make informed decisions about their future.

Follow me on the Twitter!

I have finally joined the twitter! Follow me @grownupwithJRA. There has been a fantastic #chroniclife movement on twitter and although I am late to the game, I thought I would start my new twitter account by tweeting every time my JRA affects my life for the rest of the day/night. The #chroniclife movement is about promoting awareness about how chronic, invisible illnesses affect people's lives so frequently throughout their daily lives. 

Follow @grownupwithJRA

Seventeen Stitches to the Sunshine State

At around 11:30 AM on Saturday morning, about 6 hours before I needed to be at the airport to catch a plane for a much needed week vacation in the Florida sun, I was washing dishes in the sink. This particular morning I was washing a rather large, glass salad bowl. As I turned the glass bowl over to wipe it dry, it slipped and fell into the drying rack, shattering into many large and small pieces. One such piece sliced directly into the palm of my left hand. As soon as I felt the sharp, stinging burn of the cut and saw the gaping wound in my left hand, I knew I was in trouble and immediately went to "The Bad Place." I grabbed paper towels and applied pressure without investigating it much further and immediately called for help. As I waited for my father and husband to come pick me up, I tried to distract myself from the pain by catching up on my fellow RA bloggers, just hoping that I wouldn't pass out alone in my apartment. 

An hour later I had arrived at the ER, was checked in and was waiting for the Physician Assistant to examine my injured hand. Every nurse and technician who entered, greeted me by saying "I heard you did a good job on your hand." Fortunately, like most things in life, it could have been a lot worse! Apparently, if you have to slice your hand, I picked the best spot to do it. I missed any arteries or tendons and was still able to move and feel all my fingers. Seventeen stitches and 10cc of lidocaine later, I was stitched up and discharged. With amazingly 3 hours to go before our plane for Florida departed.

My hand is by no means healed. The cut wraps around from the side of my hand to the bottom corner of my palm. It is black and blue all over and numb around the wound. Currently it looks like a shark took a bite out of my hand and that may be the story I tell to my forever curious pediatric patients when I can return to work. However, I was still able to make my flight to Florida and lying on a beach is nice place to build skin cells!